This application claims the benefit of utility application Ser. No. 13/784,364 filed Mar. 4, 2013, entitled Improved System and Method for Cleaning a Cannula during a Surgical Procedure, by Dr. Ronald Hurst, said utility application claiming the benefit of provisional application 61/742,011 filed Aug. 1, 2012, entitled Cannula and Scope Cleaning Apparatus and Associated Methods of Use, by Dr. Ronald Hurst, Both applications are hereby incorporated by reference.
The present disclosure generally relates to the field of surgery. In particular, the disclosure relates to instrumentation utilized during invasive procedures. More particularly, disclosed herein are apparatus and associated methods of use that provide cleaning of a cannula (or other access device), as well as cleaning for a viewing scope (e.g. laparoscope and other viewing scopes) for example, during particular invasive surgical procedures.
Minimally invasive surgical (MIS) procedures, which typically utilize viewing scopes, provide various advantages over open surgical procedures. In an open surgical procedure, a patient's skin and tissues are cut such that operating personnel are granted direct access to patient structures or organs. Such cuts and openings are necessarily of significant size in order for the structures and tissues involved to be seen and readily accessible. Accordingly and undesirably, patient structures or organs are thus directly exposed to the air of the operating room (which increases the exposure of the patient's structures or organs to possible contaminants) and results in large incisions that require longer recovery times as compared to MIS procedures. MIS procedures, on the other hand, typically provide the patient with several advantages including reduced blood loss, reduced post-operative patient discomfort, shortened recovery and hospitalization time, smaller incisions (e.g. minimized scarring) and reduced exposure of internal organs to possible contaminants.
As mentioned above, MIS procedures generally utilize viewing scopes, such as laparoscopes permitting remote visualization of a surgical site within a patient's body as the surgical procedure is being performed. For example and during a laparoscopic procedure, the patient's abdominal or pelvic cavity is accessed through two or more relatively small incisions rather than through a single large incision that is typically utilized during conventional surgery. Exemplary procedures which may be performed laparoscopically include, but are not limited to, cholecystectomy, hysterectomy, gastrectomy, appendectomy, bowel resection, herniorrhaphy, ovarian cystectomy and the like.
Viewing scopes, such as laparoscopes, usually consist in part of a rigid rod or shaft having a lens at one end (a distal end) and an eyepiece and/or integrated visual display at the other. The viewing scope may also be connected to a remote visual display device or a video camera to record the surgical procedure.
As previously mentioned, during laparoscopic surgery one or more small incisions are formed in the abdomen, and a trocar within a cannula is inserted through the incision to form a pathway providing access to an abdominal cavity, for example. The trocar, which by insertion into the patient is typically then soiled by bodily tissue and/or fluid, is subsequently withdrawn from the abdominal cavity and within the cannula, leaving behind bodily tissue and/or fluid on the inside surface of the cannula. If the cannula is to be utilized in conjunction with a viewing scope, it is found that upon insertion of a viewing scope therethrough, the viewing scope becomes soiled and in particular a lens portion (portion of the viewing scope which picks up the operative field) becomes obstructed, interfering with and obstructing a clear view of the internal operative field.
During a typical MIS procedure, viewing scopes are inserted and removed through a cannula multiple times, during which time operations at the surgical site and/or each insertion and each removal the viewing scope encounters blood, bodily fluids, pieces of tissue, fat or other bodily material that can adhere to the scope's lens portion and fully or partially impede visibility. Furthermore and much like the withdrawal of the trocar upon initial insertion of the cannula, a viewing scope can draw fluid from inside a patient's body into the cannula, where the fluid is deposited and can be picked up by the viewing scope when reinserted into the cannula. As a result, visualization through the viewing scope can be significantly diminished. Minimization or elimination of repetitive withdrawal and insertion of the viewing scope from the patient through the cannula is desirous, however, the viewing scope's lens requires cleaning to restore visibility, often several times during a single surgical procedure. Typically, the only solution to fogging/condensation and debris collection on the lens is removal of the viewing scope from the body cavity and defogging or cleaning the lens by wiping it with a cloth, warming the scope tip, or utilizing another defogging method such as provided by Dexide, Fort Worth, Tex., which sells a fog reduction/elimination device (FRED™) which comprises a sponge and a bottle of cleaning solution, whereby a viewing scope is removed from the patient to permit cleaning by wiping the lens portion onto the sponge. It has also been proposed to incorporate a spray wash nozzle on the viewing scope itself and/or in conjunction with introducing a flow of gas across a lens portion in order to permit cleaning of a lens portion without removing the scope from the patient. While addressing the needs of efficiency, the requirement of incorporating a washing system in the viewing scope itself does not permit cleaning of existing viewing scopes that are already in use. Such viewing scopes can be relatively expensive, limiting the ability to replace such scopes with models incorporating a wash system. Other methods and apparatus for cleaning a scope lens are disclosed in U.S. Pat. No. 5,375,589 filed Oct. 18, 1993; U.S. Pat. No. 5,392,766 filed Oct. 6, 1993 and U.S. Patent Application Publication Pub. No. US 2006/0293559, filed Jun. 24, 2005, all herein incorporated by reference in their entirety.
The need to remove the viewing scope to defog and remove debris from the lens portion is an inconvenience that interrupts and undesirably prolongs surgical procedures, increasing the chances of complications and contamination through repeated viewing scope insertion and removal.
Therefore it would be desirable to provide alternative apparatus and methods for cleaning surgical viewing scopes in situ, i.e., without the need to remove the viewing scope from the patient, as well as an apparatus that cleans and maintains the cleanliness of a cannula utilized in conjunction with the viewing scope. Such apparatus and methods should preferably require minimum or no modification of the viewing scope and preferably require minimum or no modification of other instruments used in performing the surgical procedure, e.g., cannulas used for introducing the viewing scope into a subject. Such apparatus and methods can be very effective in removing contaminating debris and fogging of the distal lens of the viewing scope as well as clearing and maintaining cleanliness of the cannula, should be convenient to use, and be low-cost to implement. Some or all of these objectives will be met by the various embodiments described hereinafter.